This is a proposal to complete and report the analysis of data relating to the recognition, response and long term adaptation to severe mental illness on the part of families of mental patients as reconstructed through interviews with the patient's spouse beginning soon after initial hospitalization and carried through the period of hospitalization. Data collected from more than 80 families in Washington, D.C. and Maryland suburbs in 1952-60 have been supplemented by two series of interviews with spouses of patients in 1971-73, one obtained in the Washington area and the other in the San Francisco Bay Area. In addition, most of the families and patients seen in 1952-60 were followed up to assess factors influencing the long-term impact of mental illness and hospitalization. The time span covered permits inferences as to how major changes in community mental health facilities influenced the meaning and consequences of the patient's illness for his or her family.